优化对患有二次并发症的高血压患者的抗高血压管理:初级保健机构的系统审查和元分析
Sulaiman Althuwaikh1, Ibrahim Albassam2, Abdulrahaman Alrashed3
1Internal Medicine, Al-Amiri Hospital, Kuwait City, KWT.
Cureus
|September 26, 2023
概括
对高血压管理的临床专注策略在改善血压控制方面表现出有限的有效性. 医生教育和电子决策支持系统在患有二次并发症的患者中没有显著降低腹压血压.
科学领域:
- 心血管医学 心血管医学
- 医疗保健服务研究 医疗服务研究
- 临床药房 临床药房
背景情况:
- 高血压管理是复杂的,随着初级保健质量的变化影响结果.
- 非药物和数字干预为改善血压控制提供了潜在的解决方案.
- 需要有效的策略来提高抗高血压药物的处方和患者的治疗结果,特别是用于二次预防.
研究的目的:
- 评估以临床医生为导向的战略,以改善初级保健中的高血压管理.
- 评估干预措施在增强抗高血压处方和血压控制方面的有效性.
- 确定对患有并发症的高血压患者的二次预防的最佳方法.
主要方法:
- 自2010年以来发表的随机对照试验 (RCT) 的系统综述和元分析.
- 在PubMed和Embase数据库中搜索了关于初级保健中临床医生专注干预的研究.
- 包括四个RCT检查医生教育和电子决策支持系统.
主要成果:
- 在对照组中,缩血压显著降低 (平均差异为2.12 mmHg,P=0.0003).
- 两组间的透气血压没有观察到统计学上显著的差异 (平均差异为1.22 mmHg,P=0.16).
- 干预措施包括医生教育和电子决策支持系统.
结论:
- 目前以临床医生为导向的策略在显著改善血压控制以预防高血压的二次预防方面表现出有限的有效性.
- 相关研究的稀缺性限制了研究结果的概括性.
- 需要进一步的研究来开发和验证高血压管理的有效干预措施.
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